Patient is a 4 year old MN Springer Spaniel dog with a history of limping and favoring left hind leg for the past few months.
Physical exam- pain with hyperextension of left stifle. Cranial drawer in flexion, CTT, medial buttress sign left stifle.
Patient is a 4 year old MN Springer Spaniel dog with a history of limping and favoring left hind leg for the past few months.
Physical exam- pain with hyperextension of left stifle. Cranial drawer in flexion, CTT, medial buttress sign left stifle.
Left stifle joint:
The supra- and infrapatellar recess of the left stifle joint contain a moderate and mild amount of effusion respectively. The joint capsule reveals moderate to severe thickening. Moderate synovial proliferations are noted. The cartilage layers as appreciated within the patellar sulcus at the femoral trochlea and onto the femoral condyles are even in thickness and smooth in outline towards the
joint surface but irregular in outline and increased at the periphery. The subchondral
bone of the femoral condyles as appreciated reveals multifocal irregularity. A moderate amount of osteophytes are noted at the femoral trochlea next to the sulcus of the patella and the periarticular margins of the femorotibial joint. An echogenic stump of disrupted fibres is seen at the distal insertion of the cranial cruciate ligament (CCL). Superficial/cranial to the stump a band of irregular but
continuous residual fibres can be traced proximally towards the femoral condyles. Mild
periligamentous effusion is present. The infrapatellar fat body is heterogenous and increased in echogenicity. The medial meniscus is in situ with mildly undulating surface and few echogenic foci. No superficial tearing is seen. There is no perimeniscal effusion. The lateral meniscus
is in situ with even surface and uniform echogenicity. No meniscal disruption is seen.
No perimeniscal effusion is noted. A small amount of echogenic fibrous tissue is seen
superficial/lateral to the lateral meniscal surface. A linear echogenic shadowing structure of 0.5 cm length is seen in the region of the infrapatellar fat pad, which is compatible with a mineralization.
The left stifle joint is affected by a moderate generalized chronic degenerative joint
disease with joint effusion, cartilage degeneration, subchondral bone sclerosis,
osteophytosis, synovial proliferation and capsular fibrosis.
The ultrasonographic findings are compatible with cranial cruciate ligament pathology
with biomechanical failure due to partial rupture. The residual fibres are irregular in
course and echotexture.
Moreover the changes suggest medial meniscal degeneration. A meniscal tear is not
seen.
